超声引导下甲状腺注射地塞米松治疗亚急性甲状腺炎疗效观察  

Efficacy of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis

作　　者：杜馥曼[1] 谭丹丹[2] 张秀坤[1] 孙雅南 张晶[1] 杨筱瑶 Du Fuman;Tan Dandan;Zhang Xiukun;Sun Yanan;Zhang Jing;Yang Xiaoyao(Department of Endocrinology,Nangang Branch of Heilongjiang Provincial Hospital,Harbin 150001,Heilongjiang Province,China;Department of UItrasonic Diagnosis,Nangang Branch of Heilongjiang Provincial Hospital,Harbin 150001,Heilongjiang Province,China;Department of Science and Education,Heilongjiang Provincial Hospital,Harbin150036,Heilongjiang Province,China)

机构地区：[1]黑龙江省医院南岗院区内分泌科,哈尔滨150001 [2]黑龙江省医院南岗院区超声科,哈尔滨150001 [3]哈尔滨150001,黑龙江省医院科教部,哈尔滨150036

出　　处：《中国基层医药》2025年第1期2-6,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：黑龙江省自然科学基金(LH2021H062);黑龙江省卫生健康委科技计划(20220303060720)。

摘　　要：目的观察超声引导下甲状腺局部注射地塞米松治疗亚急性甲状腺炎(SAT)的临床疗效与安全性。方法采用随机对照研究,选取2022年6月至2023年3月在黑龙江省医院内分泌科门诊治疗的SAT患者32例,按照随机数字表法分为观察组、对照组各16例。观察组予超声引导下甲状腺病变部位注射地塞米松,5 mg/次,1次/周;对照组予口服醋酸泼尼松片治疗,5 mg/次,3次/d,两组疗程4周。比较两组临床疗效、体温降至正常时间、疼痛消失时间、甲状腺肿大消退时间、甲状腺功能恢复正常时间以及复发率和不良反应。结果观察组有效率为100%(16/16),明显高于对照组的75%(12/16),差异有统计学意义(χ^(2)=4.57,P=0.033)。观察组体温降至正常时间[(3.5±3.6)d]、疼痛消失时间[(7.4±2.5)d]、甲状腺肿大消退时间[(11.6±7.4)d]均明显短于对照组的(6.1±3.2)d、(9.9±3.5)d、(16.9±6.8)d,差异均有统计学意义(t=-2.16、-2.33、-2.11,均P<0.05)。治疗4周后,观察组身体质量指数、空腹血糖和血清三酰甘油均显著低于对照组,差异均有统计学意义(t=-2.07、-2.46、-2.13,均P<0.05)。观察组复发率为0,明显低于对照组的25%(4/16),差异有统计学意义(χ^(2)=4.57,P=0.033)。结论超声引导下甲状腺局部注射地塞米松治疗SAT的有效性及安全性优于口服方案。ObjectiveTo investigate the clinical efficacy and safety of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis(SAT).MethodsThis is a randomized controlled study involving 32 patients with SAT who received treatment at Endocrinology Clinic of Heilongjiang Provincial Hospital between June 2022 and March 2023.The patients were randomly divided into an observation group and a control group(n=16 per group)using a random number table method.The observation group received ultrasound-guided injection of dexamethasone(5 mg per injection,once a week)into the thyroid lesion,while the control group was treated with oral prednisone acetate tablets(5 mg per dose,three times a day).Both groups were treated for 4 weeks.The clinical efficacy,time taken for body temperature to return to normal,time for pain resolution,time for goiter regression,time for thyroid function to normalize,as well as recurrence rates and adverse reactions,were compared between the two groups.ResultsThe response rate in the observation group was 100%(16/16),which was significantly higher than that in the control group[75%(12/16),χ^(2)=4.57,P=0.033].The time taken for body temperature to return to normal,the time for goiter regression,and the time for goiter regression in the observation group were(3.5±3.6)days,(7.4±2.5)days,and(11.6±7.4)days,respectively,which were significantly shorter than those in the control group[(6.1±3.2)days,(9.9±3.5)days,(16.9±6.8)days,t=-2.16,-2.33,-2.11,all P<0.05].After 4 weeks of treatment,the observation group showed significantly lower body mass index,fasting blood glucose,and serum triglyceride levels compared to the control group(t=-2.07,-2.46,-2.13,all P<0.05).The recurrence rate in the observation group was 0%,which was significantly lower than that in the control group[25%(4/16),χ^(2)=4.57,P=0.033].ConclusionsThe efficacy and safety of ultrasound-guided local thyroid injection of dexamethasone for the treatment of SAT are superior to those of the oral treatment regimen.

关 键 词：甲状腺炎 亚急性 超声检查 注射 病灶内 地塞米松 

分 类 号：R581.4[医药卫生—内分泌]